[PRACTICE NOTE] Stronger Together: Making Customer Outcomes a Shared Accountability
Organizations tend to solve a problem by naming someone to carry it. The naming feels like progress, because it produces a team, a budget line and a quarterly report. In pharma the problem named that way is the customer, and the people who carry it sit in customer care, customer experience or customer success. They are often among the most committed people in the building.
That commitment can be the reason nothing structural changes. When a small group absorbs the distance between what a company promises and what a customer can actually realize, the distance stops reading as a design problem. It becomes a staffing question instead, and staffing questions get managed rather than resolved. Nobody designs this outcome on purpose.
The objective of resequencing organizational DNA is to make customer outcomes a shared accountability across all levels and all corners of the organization. The alternative is placing that responsibility on the shoulders of a few individuals and hoping they can carry it. Instilling shared accountability is a cultural change with both a philosophical and a practical dimension. It tends to prove more enduring than routine cost takeout or technology led transformation, because it changes what a company is predisposed to do.
The cultural change has a philosophical and a practical dimension
Philosophically, the change means creating and internalizing a shared belief system built around helpfulness, which builds preference by helping customers reach their desired outcomes at an elevated standard. In practical terms it means defining company specific principles, knowledge, skills and capabilities, then cascading them into the ways of working of individuals, teams and whole departments. Neither dimension works alone. Belief without ways of working stays decorative, and ways of working without belief decay the moment a quarter gets difficult.
This is where most customer programs in pharma stall. They are built as functional capability inside one department, measured by instruments only that department controls, and defended each year by people with no line to revenue. A program designed that way can be excellent and still be structurally disposable. The question of who owns customer experience in pharma usually gets answered with a name, when ownership has to be distributed and the joins owned.
Pharma is well designed at the center and silent at the joins
A pharmaceutical commercial organization is unusually well designed at the center of each function. Medical affairs, market access, brand, field, patient services and trade each hold deep capability, clear metrics and genuine expertise. The same organization is unusually silent at the joins between them. Benefit verification, prior authorization, affordability, specialty pharmacy coordination, onboarding and first fill each sit partly inside a function and wholly inside none.
The failures therefore cluster precisely in the spaces no organization chart describes. Nobody is failing. The chart has no line for the thing that fails. Gartner measured what that silence costs elsewhere, finding that 62% of customer service channel transitions are high effort for the customer, which is the handoff problem stated as a number.
Reading this as a character gap leads to the wrong remedy every time. More training, more passion and more escalation can raise the ceiling on what committed people manage to deliver, without changing what the system delivers when nobody is watching. The work described in organizational DNA for pharma runs deeper, toward a company that is structurally predisposed to deliver well rather than one that relies on individuals to rescue the design. Heroics in that setting operate as a subsidy, paid by employees and invisible in the accounts.
Cascading Customer Excellence turns partnership into structure
Cascading Customer Excellence is the mechanism that moves customer outcomes out of one team's remit and into shared possession. It works through knowledge diffusion rather than advocacy, which matters because advocacy may depend entirely on the energy of whoever is advocating. Rather than relying on isolated champions to carry the message, a company equips a critical mass of employees with a common language for how customers are to be viewed, valued and treated. The channels are ordinary. Interpersonal conversation, formal learning, internal communications and mentoring all carry the same content into different corners.
In pharma that diffusion has a particular target. The people who encounter a broken journey first are rarely the people who hold the budget to repair it. That gap makes the voice of the frontline the earliest available signal of where value is leaking. Diffusion gives that signal somewhere to land. A field colleague equipped with shared language can describe a barrier in terms the brand team can act on, instead of filing a frustration nobody can classify.
Codified principles make good intentions trainable
Codifying the obligation to customers through company specific Customer Excellence principles turns good intentions into something that can be understood, trained, implemented and sustained. Principles do work that values statements cannot, because they describe behavior at the level of a decision rather than at the level of a sentiment. They also become the reference point for coaching, for performance conversations and for the ordinary supervisory moments where culture is transmitted.
Long before pharma, the discipline I learned at The Ritz-Carlton Leadership Center rested on exactly this. The Credo names the genuine care and comfort of guests as our highest mission. The Service Values put that obligation in the first person, with each employee empowered to create unique, memorable and personal experiences for guests. The point is one mission held by everyone, rather than four missions held by four departments. The pharma translation drops the hotel script and keeps the discipline of writing down what helpfulness means when the customer is a clinician under time pressure or a patient waiting on coverage.
Co-design is how adoption gets de-risked from the inside
A customer centric culture must be created and owned from inside the organization. Outsiders can facilitate the design process, and some of that facilitation is genuinely useful, but the culture itself has to flow from the collective consciousness of the company. The practical form is a multidisciplinary design team of culture carriers and respected corporate citizens, drawn deliberately from across functions and levels. Employee led co-design is itself an activation strategy, because participation produces ownership and ownership produces accountability.
In pharma the composition of that team decides the outcome, and I have not seen a shortcut around it. Medical, market access, field, patient services, digital and compliance each hold a different piece of the truth about where a journey breaks, and none of them holds enough of it alone. A principle written by one function often reads as that function's agenda when it reaches the others. A principle written by all of them becomes the only artifact in the building that describes the joins.
Shared accountability becomes diffuse accountability without a named owner
The honest difficulty with shared accountability is that it can dissolve into nobody's accountability. A company that tells everyone they own the customer has often told nobody in particular. Partnership between functions is a precondition for good outcomes rather than a substitute for ownership, and that distinction tends to get lost in the enthusiasm of a culture program. Every consequential handoff needs one named owner, with the authority and the measurement to match the name.
USAA built this into its operating model through Experience Owners, designated individuals who serve as stewards of excellence across one or more journeys. In the commercial organizations I have worked inside, the handoffs that fail most often are the ones everybody can describe and nobody is measured on. The pharma equivalents are ordinary rather than exotic. Someone owns the move from benefit verification to first fill, someone owns the move from enrollment to shipment, and someone owns the week a patient goes quiet.
Gartner found that low effort customers are 61% more likely to stay, which puts a price on every transition a company leaves unowned. Forrester reported that customer obsessed organizations achieved 41% faster revenue growth than the rest, a gap no single function can produce on its own. Shared accountability earns a gap like that only when it resolves into named owners at the points where value changes hands.
Customer consciousness is the test of whether partnership is real
Customer consciousness is the degree to which customer reality is present in decisions before they are made, rather than sentiment about customers. The definition is deliberately unsentimental, because sentiment is abundant in pharma while consequential presence is rare. The useful test has little to do with whether people in a meeting care about patients. The test is whether anyone in the room could describe what the next fourteen days will require of that patient.
Raising customer consciousness is the purpose of Customer Excellence, and shared accountability is how it scales past the few people who already have it. A company that is structurally predisposed to deliver well admits customer reality into decisions as a matter of routine, through principles, through diffused knowledge and through owners present at the joins. A company that relies on conviction admits customer reality whenever a committed individual happens to be invited. The second arrangement produces better meetings and worse systems.
No single function can move the Realization Rate
The share of earned value that becomes sustained therapy is the Realization Rate, calculated as realized value divided by earned value. The number falls in the gaps between the Path to Prescribe, the Path to Fulfill and the Path to Adhere, exactly where no function owns outright. Pharma does not have a sales problem, it has a systemic value realization problem, and that distinction decides where the remedy has to sit. No brand team can move the Realization Rate alone, no patient services team can, and no field organization can.
Bain put the underlying economics plainly, describing goodwill as a necessary but insufficient condition for generating revenue growth. Pharma's version of that insufficiency is a therapy genuinely needed, covered and prescribed, which still fails to reach a patient who gave up somewhere in the administrative middle. Converting goodwill into realized value asks every function to carry a piece of the same number. That obligation is the whole of the argument for partnership, and it is also the limit of it.
Key Takeaways
- Accountability for customer outcomes in pharma often sits with a small group whose commitment allows the surrounding structure to remain unchanged.
- A pharmaceutical commercial organization tends to be well designed at the center of each function and silent at the joins where journeys actually break.
- Cascading Customer Excellence through knowledge diffusion and company specific principles turns partnership into structure rather than goodwill.
- Employee led co-design operates as an activation strategy, because participation produces ownership and ownership produces accountability.
- Shared accountability becomes diffuse accountability unless every consequential handoff carries one named owner with measurement attached.
- No single function can move the Realization Rate, which is the practical reason partnership across functions matters.
Diagnostic Questions to Consider
- Name the group that currently carries customer outcomes in your organization, and describe what would change if that group were reduced.
- List the handoffs between benefit verification, prior authorization, affordability support and first fill, and name the single owner of each.
- Describe the company specific Customer Excellence principles your organization has codified, and where they appear in training and performance conversations.
- Identify who was in the room the last time a patient support journey was designed, and which functions were absent from it.
- State your current Realization Rate and name the function that is measured on moving it.
Closing Reflection
Shared accountability endures longer than most transformation agendas because it changes the organization's default rather than its initiative list. Cost takeout removes capacity. Technology programs change speed. Resequencing organizational DNA changes what a company does when nobody is supervising, which is the only condition under which customers ever experience a company.
The work is slower than a reorganization and less satisfying than a launch, because its evidence arrives as the absence of failures that would otherwise have happened quietly. A patient who never had to call twice generates no story. A clinician who never had to chase a coverage decision writes no complaint. The value appears only later, in the Realization Rate, as a number no single function can claim credit for.
Partnership across functions is therefore worth building for an unsentimental reason. It remains the only arrangement under which the commercial system can finish what the science started. Exceptional science deserves an exceptional commercial system, and an exceptional commercial system is one where the joins have owners.
About the Author
Wayne Simmons is the founder of The Customer Excellence AGENCY and the author of The Customer Excellence Enterprise (Wiley, 2024). He is founding faculty of the MS in Customer Experience Management at Michigan State University's Broad College of Business. He led global customer excellence in Pfizer's first Chief Marketing Organization and in Bayer's Customer Powerhouse.
The Customer Excellence Agency: Advancing the Pursuit of Excellence in Service of Science.
